Evaluation of Universal Screening for Substance Use Risk on a Labor and Delivery Unit in Rural Pennsylvania

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Substance Use Disorders

Background:

• Rural Pennsylvania faces higher-than-average rates of perinatal substance and opioid use.
• Universal screening for substance use in labor and delivery (L&D) settings is crucial for early identification and intervention.
• Existing screening protocols may require optimization for efficiency and effectiveness.

Purpose of the Study:

• To evaluate the implementation and effectiveness of a new universal substance use screening process on an L&D unit.
• To assess screening rates, provider follow-up, and staff perceptions of a specific screening tool.
• To identify areas for improvement in a perinatal substance use screening program.

Main Methods:

• A focused program evaluation was conducted using the CDC Framework for Program Evaluation.
• Data were collected from 570 women and 22 maternity care providers on an L&D unit in rural Pennsylvania.
• Screening rates, follow-up rates for at-risk screens, and staff perceptions of the NIDA Quick Screen/ASSIST were analyzed.

Main Results:

• The universal screening rate achieved was 89%, surpassing the health system's goal of 80%.
• Maternity care providers initiated appropriate follow-up for at-risk screens in 88% of cases, falling short of the 100% goal.
• Staff reported the NIDA Quick Screen/ASSIST as acceptable, appropriate, and feasible for identifying substance use risk.

Conclusions:

• The implemented universal screening process demonstrated a high screening rate on the L&D unit.
• Provider follow-up rates indicate a need for enhanced protocols and support to achieve optimal patient care.
• Staff feedback highlighted opportunities to streamline the screening process, improve education, and strengthen patient follow-up mechanisms.